荷兰医改及对我国构建整合型健康服务体系的启示

The Netherland health reform experiences and its enlightenment for the construction of China’s integrated healthcare service system

本文介绍了荷兰卫生服务体系概况,重点阐述了荷兰新医改后的全科医生首诊制度、“有管理的竞争模型”健康保险体系、长期照护体系典型政策范例。借鉴荷兰改革经验,提出推进我国卫生服务体系整合实践的策略。建议:以提高全科医生职业吸引力作为改革起点,全科医生队伍建设先行,筑牢改革根基;立法先行、以市场机制作为改革抓手,搭建公共政策规制与市场激励相容的改革框架,形成一套富有管理的、有竞争性、有活力的中国健康保险体系;在积极健康老龄化背景下,以整合理念建设适合我国国情的老年人长期照护体系;承接我国移动互联领域的资源基础,依托智慧治理破解医改难题。

This paper introduces an overview of the Dutch health system and describes its typical characteristics after their 2006 health reforms, including general practitioner "gatekeeper" system,"managed competition" health insurance system and long-term care system. Based on the reform experiences come from Dutch health system reform, this paper puts forward some reform strategies to promote the integration of health service system in China. This paper suggests that:First of all, it is of vital importance to promote the construction of general practitioners (GPs) team by increasing the career attraction of GPs in China. Second, a dynamic, managed competition China health insurance system should be established;and the legislative act and the market competition as a driving force of health reform should be emphasized to build a reform framework which involves both of public policy regulation and market incentives. Third, under the background of active and health ageing population, and due to the fact that the health expectancy is enlarging, a long-term care system for the elderly should be constructed according to a series of integrated reform conditions in the national system to meet the challenges. Last but not least, intelligent governance relying on the resource base of China's mobile Internet field should be undertook to improve the process of China's medical reform thereby solving all of the incurring problems.